Orthodontic indiret bonding tray including stablization features

ABSTRACT

A tray for use in bonding orthodontic appliances to selected teeth of a patient is disclosed. The tray includes an outer shell having wall sections extending over facial, lingual, and occlusal surfaces of the selected teeth to form a channel including tooth cavities having a configuration matching and arranged for receiving the selected teeth. A matrix is bonded to the inner surface of the outer shell and is contoured to complement the facial or lingual surface of the teeth. A stabilization member extends from the outer shell and includes an inside surface contoured to complement at least a portion of the facial surface of a tooth located adjacent the selected teeth. Orthodontic appliances are detachably connected to the matrix, wherein each appliance includes a base for bonding the appliance to a tooth.

FIELD OF THE INVENTION

This invention relates to method and apparatus for bonding orthodonticappliances such as brackets to a patient's teeth. The present inventionspecifically relates to an indirect bonding tray including stabilizationfeatures.

BACKGROUND OF THE INVENTION

Orthodontic treatment involves movement of malpositioned teeth todesired locations in the oral cavity. Orthodontic treatment can improvethe patient's facial appearance, especially in instances where the teethare noticeably crooked or where the jaws are out of alignment with eachother. Orthodontic treatment can also enhance the function of the teethby providing better occlusion during mastication.

One common type of orthodontic treatment involves the use of tiny,slotted appliances known as brackets. The brackets are fixed to thepatient's teeth and an arch wire is placed in the slot of each bracket.The arch wire forms a track to guide movement of teeth to desiredlocations.

The ends of orthodontic arch wires are often connected to smallappliances known as buccal tubes that are, in turn, secured to thepatient's molar teeth. In many instances, a set of brackets, buccaltubes and an arch wire is provided for each of the patient's upper andlower dental arches. The brackets, buccal tubes and arch wires arecommonly referred to collectively as “braces”.

In many types of orthodontic techniques, the precise position of theappliances on the teeth is an important factor for helping to ensurethat the teeth move to their intended final positions. In general,orthodontic appliances that are adapted to be adhesively bonded to thepatient's teeth are placed and connected to the teeth by either one oftwo techniques: a direct bonding technique, or an indirect bondingtechnique.

In the direct bonding technique, the appliance and adhesive are graspedwith a pair of tweezers or other hand instrument and placed by thepractitioner on the surface of the tooth in an approximate desiredlocation. Next, the appliance is shifted along the surface of the toothas needed until the practitioner is satisfied with its position. Oncethe appliance is in its precise, intended location, the appliance ispressed firmly onto the tooth to seat the appliance in the adhesive.Excess adhesive in areas adjacent the base of the appliance is removed,and the adhesive is then allowed to cure and fix the appliance firmly inplace. While the direct bonding technique described above is inwidespread use and is considered satisfactory by many, there areshortcomings that are inherent with this technique. For example, accessto surfaces of malposed teeth may be difficult. In some instances, andparticularly in connection with posterior teeth, the practitioner mayhave difficulty seeing the precise position of the bracket relative tothe tooth surface. Additionally, the appliance may be unintentionallydislodged from its intended location during the time that the excessadhesive is being removed adjacent the base of the appliance.

Indirect bonding techniques avoid many of the problems associated withdirect bonding. In general, indirect bonding techniques known in thepast have involved the use of a placement device or transfer apparatushaving a shape that matches the configuration of one or more of thepatient's teeth in the dental arch. One type of placement device ortransfer apparatus is often called a “transfer tray” and typically has acavity for receiving a number of teeth simultaneously. A set ofappliances such as brackets are releasably connected to the tray atcertain, predetermined locations.

During the use of an orthodontic transfer apparatus for indirectbonding, an adhesive is typically applied to the base of each applianceby the orthodontist or a staff member. The device is then placed overthe patient's teeth and remains in place until such time as the adhesivehardens. Next, the apparatus is detached from the teeth as well as fromthe appliances, with the result that all of the appliances previouslyconnected to the apparatus are now bonded to respective teeth at theirintended, predetermined locations.

In more detail, one method of indirect bonding of orthodontic appliancesusing the transfer tray described above includes the steps of taking animpression of each of the patient's dental arches and then making areplica plaster or “stone” model from each impression. Next, theappliances are bonded to the stone models at desired locations.Optionally, the brackets may be adhesive precoated brackets.

The transfer tray is then made by placing a matrix material over themodel as well as over the appliances placed in the model. For example, aplastic sheet matrix material may be held by a frame and exposed toradiant heat. Once the plastic sheet material has softened, it is placedover the model and the appliances. Air in the space between the sheetmaterial and the model is then evacuated, and the plastic sheet materialassumes a configuration that precisely matches the shape of the replicateeth of the stone model and attached appliances. The plastic sheetmatrix material is then allowed to cool and harden to form a tray. Thetray and the appliances (which are embedded in an interior wall of thetray) are then detached from the stone model. If the cured adhesive thatwas used to bond the appliances to the stone model remains on the baseof the appliances after detachment from the stone model, the adhesiveserves as a “custom” base having a concave contour that preciselyreplicates the convex contour of the previous attachment location of thestone model, as well as the convex configuration of the intendedmounting location of the appliances on the patient's teeth.

Once the patient has returned to the practitioner's office, a quantityof adhesive is placed on the base of each appliance, and the tray withthe embedded appliances is then placed over the matching portions of thepatient's dental arch. Since the configuration of the interior of thetray closely matches the respective portions of the patient's dentalarch, each appliance is ultimately positioned on the patient's teeth atprecisely the same location that corresponds to the previous location ofthe same appliance on the stone model.

Indirect bonding techniques offer a number of advantages over directbonding techniques. For one thing, and as indicated above, it ispossible to bond a plurality of appliances to a patient's dental archsimultaneously, thereby avoiding the need to bond each appliance inindividual fashion. In addition, the transfer apparatus helps to locatethe appliances in their proper, intended positions such that adjustmentof each appliance on the surface of the tooth before bonding is avoided.The increased placement accuracy of the appliances that is oftenafforded by indirect bonding techniques helps ensure that the patient'steeth are moved to their proper, intended positions at the conclusion oftreatment.

In recent years, many improvements have been made in the field ofindirect bonding. However, there is a continuing need in the art toimprove methods for fabricating the transfer apparatus or transfer tray.For example, improper fit of the transfer tray over the patient's teethis a common problem. For example, when a practitioner utilizes anindirect bonding technique, it is critical that the practitioner be ableto precisely place the transfer tray over matching surfaces of thepatient's teeth. An improperly fitted transfer tray may result inappliances being bonded to locations on the patient's teeth that areimprecise and do not correspond to the previous location of the sameappliance on the stone model. As a result, malpositioned teeth may moveto unintended positions during the treatment program.

Although the transfer tray is fabricated to match the surfaces of thepatient's teeth, as is often the case, the transfer tray may be somewhatunstable, loose, or inaccurate. Such instability can result from severalfactors. For example, inaccuracies may arise during the steps leading upto the fabrication of the transfer tray. Inaccuracies may arise duringfabrication of the impression of the patient's teeth, or during thefabrication of the stone model based upon each impression. Inaccuraciesmay also arise during bonding of the appliances to the stone model atdesired locations. Additionally, inaccuracies may arise due to the factthat the transfer tray is customarily fabricated of a material that isinsufficiently rigid. Due to any one or a combination of the foregoingfactors, a certain amount of instability, “wiggle”, or “play” oftenarises when the transfer tray is placed over matching surfaces of thepatient's teeth during the indirect bonding process. The potential forsuch instability increases, especially when the transfer tray isarranged for placement over only a small number of teeth, e.g., two orthree teeth.

For the foregoing reasons, it is desirable to increase placementaccuracy of the transfer tray over matching surfaces of the patient'steeth during the indirect bonding procedure. It would be desirable toprovide a transfer tray that includes a feature or mechanism that wouldprovide stabilization and enable the practitioner to visually assess ordetermine whether the transfer tray has been placed or seated onto thepatient's teeth in the position as originally planned and intended.Other than its surfaces that match a patient's teeth, currentlyavailable transfer trays (made for one or multiple teeth) do not providethe practitioner with such a feature or mechanism.

SUMMARY OF THE INVENTION

A tray for use in bonding orthodontic appliances to selected teeth of apatient is disclosed. The tray includes an outer shell having wallsections extending over facial, lingual, and occlusal surfaces of theselected teeth to form a channel including tooth cavities having aconfiguration matching and arranged for receiving the selected teeth. Amatrix is bonded to the inner surface of the outer shell and has aninner surface, a portion of which is contoured to complement the facialsurface of the selected teeth. Alternatively, a portion of the matrixinner surface may be conformed to complement the lingual surface ofselected teeth. A stabilization member extends from the outer shell andincludes an inside surface contoured to complement at least a portion ofthe facial surface of a tooth located adjacent the selected teeth.Orthodontic appliances are detachably connected to the matrix, whereineach appliance includes a base for bonding the appliance to a tooth.

DESCRIPTION OF THE DRAWINGS

FIG. 1 is an isometric view of the orthodontic indirect bonding trayincluding stabilization features of the present invention applied toteeth of the upper dental arch of a patient, the upper dental arch beingrotated one-hundred eighty degrees to illustrate the occlusal surfacesof the teeth located therein;

FIG. 2 is a view of the upper dental arch of FIG. 1 including across-sectional view of the orthodontic indirect bonding tray of thepresent invention, showing teeth in phantom;

FIG. 3 is a perspective view of the orthodontic indirect bonding trayincluding stabilization features of the present invention;

FIG. 4 is another isometric view of the orthodontic indirect bondingtray including stabilization features of the present invention; and,

FIG. 5 is a cross-sectional view of the orthodontic indirect bondingtray including stabilization features of the present invention, shownmounted over teeth.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

Referring now in greater detail to the drawings in which like numeralsrepresent like components throughout the several views, there is shownin FIGS. 1-5 an embodiment of the orthodontic indirect bonding trayincluding stabilization features of the present invention which isbroadly designated by the numeral 20. As best shown in FIGS. 1 and 2,the bonding tray 20 is shown positioned over several teeth 14 of theupper jaw 18, or maxilla, of an orthodontic patient, the teeth 14requiring corrective orthodontic alignment. FIG. 1 illustrates the upperdental arch rotated one-hundred eighty degrees to illustrate theocclusal surfaces of the teeth located therein. Although the figuresillustrate the indirect bonding tray of the present invention positionedover teeth of the upper jaw, it should be understood that it is withinthe scope of the present invention that the bonding tray 20 could bepositioned over teeth of the lower jaw.

The tray 20 includes a channel 22 (FIG. 4) comprising a plurality, e.g.three, tooth cavities for receiving selected teeth 14 within a patient'sdental arch. In the exemplary tray 20 shown in the drawings, the channel22 is adapted to receive teeth 14 located in a patient's upper dentalarch, although it should be understood in this regard that as analternative, the tray 20 may be constructed to receive teeth 14 locatedin the patient's lower dental arch (not shown).

The tray 20 also includes a number of orthodontic appliances 28 that aredetachably connected to the tray 20. In FIGS. 1-5, the exemplaryillustrated orthodontic appliance 28 is an orthodontic bracket, althoughother appliances are also possible. Examples of other suitableappliances include buccal tubes, buttons, formed “bumps” made, e.g., ofcomposite material, or any other metal or non-metal “handle” or otherstructure connected to the teeth 14 that provides an attachment pointfor a force member such as a wire, aligner tray, polymeric strip,elastomeric band or chain, or any combination of the foregoing.

Referring now to FIG. 5, the tray 20 may be constructed according to anyone of a variety of known techniques. In the example shown in FIG. 5,the tray 20 is formed of an inner matrix 26, formed of a relativelyflexible material, and an outer shell 30, which is formed of a materialthat is relatively hard in comparison to the inner matrix 26.

The inner matrix 26 has a relatively low viscosity before hardening sothat intimate contact between the inner matrix 26 and each appliance 28,e.g., orthodontic bracket, is assured. As best shown in FIGS. 1, 2 and5, three appliances 28 are shown to be in contact with the inner matrix26, although it should be understood in this regard that as analternative, the tray 20 may be constructed to receive a greater orfewer number of appliances 28. As best shown in FIG. 5, the relativelysoft inner matrix 26 is shown as penetrating the various recesses,cavities and other structural features of each appliance 28 so that asecure connection between the appliances 28 and the inner matrix 26 canbe established. In FIG. 5, the inner matrix 26 is shown as contactingthe facial surface of the tooth 14. The inner matrix 26 also includes acontour that matches and makes contact with the facial surface 14 c ofthe patient's teeth 14 in the area surrounding the appliance 28.

It should be understood that alternatively, in the event appliances 28are to be attached to the lingual surface of teeth 14, then the innermatrix 26 could be contoured to match and arranged to contact thelingual surface 14 a of the teeth 14, as opposed to the facial surface.In other words, depending upon whether appliances 28 are to be attachedto the facial 14 c or lingual 14 a surfaces of teeth 14 will dictatewhether the inner matrix 26 is to be located adjacent the facial orlingual surface of the teeth 14. Any suitable material may be utilizedfor the inner matrix 26 so long as it is relatively clear to permit acuring light to pass through the inner matrix 26 to enable curing of theadhesive for bonding the appliances 28 to the surfaces of the teeth 14.An example of a suitable material for the inner matrix 26 is Essix®Bleach Tray and Model Duplication Material (1.5 mm thickness) availablefrom Dentsply Raintree Essix, located in Metarie, Lousiana.

The relatively hard outer shell 30 includes a contour that preciselymatches the surfaces of the tooth 14 where the outer shell 30 contactsthe tooth 14, e.g., the lingual 14 a and occlusal 14 b surfaces of thetooth 14. For example, as shown in FIG. 5, the outer shell 30 directlycontacts the lingual 14 a and occlusal 14 b surfaces, as well assurrounds the inner matrix 26 over the facial surface 14 c of thepatient's teeth 14. As shown in FIG. 5, the inner matrix 26 directlycontacts the facial 14 c surface of the tooth 14. Although not shown inthe drawings, in the event appliances 28 are to be attached to thelingual surface 14 a of teeth 14, then the outer shell 30 would includea contour that precisely matches the facial 14 c and occlusal 14 bsurfaces of the tooth 14, and the outer shell would directly contactthose tooth surfaces. The outer shell 30 would surround the inner matrix26 over the lingual surface 14 a of the patient's teeth 14, the innermatrix 26 being in direct contact with this tooth surface.

Preferably, the outer shell 30 chemically bonds to the inner matrix 26with a relatively high bond strength. Any suitable material may beutilized for the outer shell 30 so long as it is relatively clear topermit a curing light to pass through the outer shell 30 to enablecuring of the adhesive for attaching the appliances 28 to the surfacesof the teeth 14. An example of a suitable material for the relativelyhard outer shell 30 is Essix A+® Plastic, also available from DentsplyRaintree Essix, located in Metarie, Lousiana.

For example, the relatively hard surface of the outer shell 30 directlycontacts the patient's teeth on the lingual 14 a and occlusal 14 bsurfaces of the teeth 14, while the relatively soft and flexible surfaceof the inner matrix 26 is limited to direct contact with the facialsurface 14 c of the teeth in the vicinity where it penetrates theappliances 28. By maximizing the amount of relatively hard outer shell30 directly contacting the teeth 14 and minimizing the amount ofrelatively soft and flexible inner matrix 26 directly contacting theteeth 14, an improved mating fit of the tray 20 with the patient's teeth14 may be obtained such that little, if any, tolerance or “slop” ispresent and relative movement between the tray 20 and the teeth 14 ofthe dental arch is substantially eliminated. In this manner, thetransfer tray 20 is sufficiently rigid in the areas where it makesdirect contact with the teeth 14. Such a construction will reduceinstability, “wiggle”, or “play” that often arises when the transfertray is placed over matching surfaces of the patient's teeth during theindirect bonding process. In this manner, heightened assurance isprovided to the practitioner that each appliance 28 will be positionedon the patient's teeth at precisely the same location that correspondsto the previous location of the same appliance on the stone model.

Moreover, as an additional feature to address the problem of inaccurateplacement of the orthodontic appliance onto a patient's tooth, the tray20 of the present invention is provided with a stabilization member 32which is shown in FIGS. 1-4 as extending in the mesial direction fromthe anterior end of the tray 20 to a tooth 34 located adjacent the teeth14 to which appliances 28 are to be applied. Although FIGS. 1-4illustrate the stabilization member 32 extending in a mesial directionfrom the anterior end of the tray 20, it should be understood that thestabilization member 32 may extend in the distal direction from theposterior end of the tray 20 to an adjacent tooth 34, also for thepurpose of increasing the accuracy of placement of the orthodonticappliance onto a patient's tooth 14. The stabilization member 32provides an extra point of contact to adjacent structure, e.g. anadjacent tooth 34, and also provides a visual confirmation to thepractitioner that a correct fit of the tray 20 that was originallyplanned for has been achieved. Such visual confirmation is especiallyimportant in cases where the tray 20 is arranged for placement overposterior teeth where the practitioner may have difficulty seeing theprecise position of the bracket 28 relative to the tooth surface.

The inner surface of the stabilization member 32 is precisely contouredto the surface of the adjacent tooth 34 and provides a visual indicatorof correct tray placement. As best shown in FIGS. 1 and 2, thestabilization member 32 is precisely contoured to match and positionedto contact the facial surface of the adjacent tooth 34. Although FIGS. 1and 2 illustrate the stabilization member 32 as being positioned andcontoured to contact the facial surface of the adjacent tooth, it shouldbe understood that the stabilization member 32 may also be preciselycontoured to match and positioned to contact the occlusal surface, orthe lingual surface of the adjacent tooth 34. Alternatively, thestabilization member 32 could be positioned and contoured to contact twosurfaces of the adjacent tooth, e.g., the facial and occlusal surfaces,or the lingual and occlusal surfaces of the adjacent tooth 34.

The stabilization member 32 may be formed of any suitable material,e.g., acrylic, acetate, resin, plastic, metal, silicone, polyvinyl, ormaterials derived from stereolitographic processes, among others. Thestabilization member 32 may also be formed of the material used to formthe outer shell 30. The stabilization member 32 may be transparent ortranslucent. The stabilization member 32 may be integral with the tray20, or a separate component that is attached to the tray 20, by anysuitable means.

It is understood that the orthodontic indirect bonding tray includingstabilization features of the present invention and its constituentparts described herein is an exemplary indication of a preferredembodiment of the invention, and is given by way of illustration only.In other words, the concept of the present invention may be readilyapplied to a variety of preferred embodiments, including those disclosedherein. While the invention has been described in detail and withreference to specific examples thereof, it will be apparent to oneskilled in the art that various changes and modifications can be madetherein without departing from the spirit and scope thereof.

1-18. (canceled)
 19. An indirect orthodontic appliance bonding systemcomprising: an indirect bonding tray configured to be disposed onselected teeth in a patient's mouth, wherein the indirect bonding traycomprises: an outer shell, wherein the outer shell comprises: a firstend; an opposing second end; and a channel in the outer shell, whereinthe channel comprises an inner surface; an inner matrix coupled to atleast a portion of the inner surface of the channel of the outer shelland coupleable to one or more orthodontic appliances, wherein the innermatrix is capable of at least partially penetrating at least a potion ofone or more of the orthodontic appliances disposed in the inner matrix,and wherein the inner matrix is relatively softer in composition thanthe outer shell; and a stabilization member coupled to the indirectbonding tray, wherein the stabilization member comprises: an attachmentend attached proximate a first end of the indirect bonding tray; and afree end extending away from the first end and the second end of theindirect bonding tray and; wherein a portion of the stabilization memberis adapted to contact part of an adjacent tooth to stabilize theindirect bonding tray when the indirect bonding tray is disposed overthe selected teeth.
 20. The indirect orthodontic appliance bondingsystem of claim 19 wherein the channel of the outer shell comprises oneor more tooth cavities, wherein a tooth cavity is configured to receiveone or more teeth of the selected teeth.
 21. The indirect orthodonticappliance bonding system of claim 19 wherein at least a portion of theinner surface of the outer shell is complementary to at least a portionof a facial surface of one or more teeth of the selected teeth.
 22. Theindirect orthodontic appliance bonding system of claim 19 wherein atleast a portion of the inner matrix comprises
 23. The indirectorthodontic appliance bonding system of claim 19 wherein the selectedteeth comprise a portion of the upper dental arch.
 24. The indirectorthodontic appliance bonding system of claim 19 wherein the selectedteeth comprise a portion of the lower dental arch.
 25. The indirectorthodontic appliance bonding system of claim 19 further comprising oneor more orthodontic appliances disposed in the inner matrix.
 26. Theindirect orthodontic appliance bonding system of claim 25 wherein theinner matrix at least partially penetrates at least a portion of anorthodontic appliance and wherein at least a portion of the inner matrixcontacts at least a portion of the facial surface of one or more teethof the selected teeth when the indirect bonding tray is disposed overthe selected teeth.
 27. The indirect orthodontic appliance bondingsystem of claim 26 wherein one or more of the orthodontic appliances aredetachably connected to the inner matrix.
 28. The indirect orthodonticappliance bonding system of claim 19 wherein the outer shell and theinner matrix allow at least a portion of a curing light to pass throughthe outer shell and the inner matrix.
 29. The indirect orthodonticappliance bonding system of claim 19 wherein the outer shell directlycontacts a lingual surface and an occlusal surface of the selectedteeth.
 30. The indirect orthodontic appliance bonding system of claim 19wherein the free end of the stabilization member extends in a mesialdirection from an anterior end of the indirect bonding tray.
 31. Theindirect orthodontic appliance bonding system of claim 19 wherein thefree end of the stabilization member extends in a distal direction froma posterior end of the tray.
 32. The indirect orthodontic appliancebonding system of claim 19 wherein the free end of the stabilizationmember contacts at least one of a facial surface of the adjacent tooth,a lingual surface of the adjacent tooth, or an occlusal surface of theadjacent tooth.
 33. An indirect orthodontic appliance bonding systemcomprising: an indirect bonding tray configured to be disposed onselected teeth in a patient's mouth, wherein the indirect bonding traycomprises: an outer shell, wherein the outer shell comprises: a firstend; an opposing second end; and a channel in the outer shell, whereinthe channel comprises an inner surface; an inner matrix coupled to atleast a portion of the inner surface of the channel of the outer shelland capable of detachably coupling with one or more orthodonticappliances; and a stabilization member coupled to the indirect bondingtray, wherein the stabilization member comprises: an attachment endattached proximate a first end of the indirect bonding tray; and a freeend extending away from the first end and the second end of the indirectbonding tray and; wherein a portion of the stabilization member isadapted to contact part of an adjacent tooth to stabilize the indirectbonding tray when the indirect bonding tray is disposed over theselected teeth.
 34. The indirect orthodontic appliance bonding system ofclaim 33 wherein the outer shell comprises wall sections, and whereinthe wall sections are configured to extend over at least the facialsurface and the occlusal surface of the selected teeth.
 35. The indirectorthodontic appliance bonding system of claim 33 wherein the outer shellcomprises wall sections, and wherein the wall sections are configured toextend over at least the lingual surface and the occlusal surface of theselected teeth.
 36. The indirect orthodontic appliance bonding system ofclaim 33 wherein the free end comprises a surface contoured toapproximately match at least one of at least part of the facial surfaceof the adjacent tooth, at least part of a lingual surface of theadjacent tooth, or at least part of the occlusal surface of the adjacenttooth.
 37. The indirect orthodontic appliance bonding system of claim 33wherein the stabilization member contacts more than one adjacent tooth.38. The indirect orthodontic appliance bonding system of claim 33further comprising one or more orthodontic appliances detachablyconnected to the inner matrix, wherein the inner matrix at leastpartially penetrates at least a portion of an orthodontic appliance.